School scoliosis screening in Hong Kong: trunk asymmetry of girls with scoliosis

Background: The school scoliosis screening aims to identify students with spinal deviations by trunk asymmetry.The objective of this study is to investigate the accuracy of scoliosis screening with a low ATR cut-off and occurrence of shoulder obliquity.Methods: 443 schoolgirls aged between 10-13 years participated in this school scoliosis screening.During the screening, a forward bending test with ATR measurement using scoliometer were adopted to detect the trunk asymmetry and the backside photographs were captured for shoulder obliquity measurement.The ATR cut-off point was 3°.Participants with ATR ≥3° were invited to conduct an ultrasound spinal examination for Cobb's angle measurement.The positive predictive value of ATR≥3° was calculated.Findings: It is found that 17.8% of the screened students possibly have early scoliosis.The positive predictive value of ATR ≥3° was 0.717.There is a significant negative correlation between the BMI range and occurrence of ATR ≥3°.55.7% of girls with ATR≥3° had shoulder obliquity.There is a significant positive correlation between the occurrence of shoulder obliquity and ATR ≥3°.